The plastic surgery and prescription violations that’ll cost a Miami doctor $26,000

A Miami plastic surgeon accused of sub-standard surgical practices and pre-signing blank prescription forms will have to come out of his pocket with $26,000 as part of his punishment from the state Board of Medicine.

Nothing in Tuesday’s final order from the board settling three of the four Florida Department of Health administrative complaints against Dr. Julio Clavijo-Alvarez affects his day-to-day business.

The settlement agreement involved no suspension or probation of the American Board of Plastic Surgery board-certified doctor. All it demanded of Clavijo-Alvarez is his time and money — the time involved in four continuing medical education courses (liposuction, risk management, records and laws, rules and ethics) and the money of a $15,000 fine and $11,085 in Department of Health case costs.

Clavijo-Alvarez continues to work out of his own Coral Gables business, Ai Hair Transplant Miami and Ai Gaia Medspa, 2100 Ponce de Leon. He’s still advertised on 305 Plastic Surgery’s website, but not listed with the Department of Health as one of its surgeons.

He’s still listed and advertised at New Life Plastic Surgery, 8400 SW Eighth St., the setting for two of the complaints.

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Bad drain placement

A Brazilian butt lift or BBL is popular form of liposuction at plastic surgery factories such as New Life. During an Oct. 28, 2021 BBL surgery, a complaint said, Clavijo-Alvarez placed a Jackson-Pratt drain under the patient’s muscles between the ribs and pubic bone, inside the abdominal cavity and under the peritoneum.

(“A Jackson-Pratt (JP) drain is a thin, flexible tube with a bulb on the end that drains fluid away from your wound after surgery,” the Cleveland Clinic explains. “ Your peritoneum is a membrane , a sheet of smooth tissue that lines your abdominopelvic cavity and surrounds your abdominal organs.”)

The complaint says the prevailing standard of care required Clavijo-Alvarez not put the drain where he did. The patient wound up going to Jackson West Medical Center with back and abdominal pain, then Jackson Memorial Hospital. JMH doctors removed the drain on Nov. 1, four days after Clavijo-Alvarez inserted it.

The complaint also said Clavijo-Alvarez, who met with the patient on Nov. 3, “reported that the patient had not experienced any pain since the BBL procedure on Oct. 28, 2021.”

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Improperly filling in the blanks

During a visit to New Life on May 27, 2022, a Florida Department of Health inspector “found one or more prescriptions for oxycodone and/or diazepam that were pre-signed by [Clavijo-Alvarez], without any patient identifying information or date, located in an unsecured area of New Life.”

Secured area or no, pre-singing blank prescription forms is a no-no.

The buck stops here

Back when Clavijo-Alvarez was at Miami Lakes Cosmetic Surgery, 15450 New Barn Rd., he served as the designated physician. That’s the doctor on staff who acts as line monitor, charged with making sure the office surgery center operates in compliance with state guidelines. Facility violations go in complaints against both the surgery center’s license and the designated physician’s license.

The complaint said at least once, a surgeon didn’t document doing or do at all, a pre-op examination; a patient wasn’t given in writing the name and location of the hospital where the doctor has staff privileges or one that has a transfer agreement with the facility or doctor; doctors didn’t always get patient’s written statement that they consented to procedures, level of anesthesia, knew the risks and that they had a choice of anesthesia provider.

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Among the other violations: a registered nurse without post-anesthesia care unit experience was used to monitor patients recovering from anesthesia.